Teenage Health Vulnerabilities with Substance Abuse US

Interventions to Reduce Adolescent Substance Abuse
The purpose of this paper is to provide a review of the relevant literature to describe current government initiatives for addressing substance abuse by adolescents in the United States. An analysis of what is being done as well as what is not being done is followed by an examination of gaps in the current initiatives. In addition, a discussion concerning the health advocacy groups that have attempted to advocate for this health issue and the possibility of collaboration with one of these groups is followed by an analysis concerning how collaboration with existing advocacy groups can further the efficacy of the program to address this public health issue. Likewise, a discussion concerning the public health theory/model/framework which can be used to guide a program and intervention of the public health issue and a description concerning the proposed intervention to address this public health issue is followed by a description concerning its administration and requisite resources. Finally, a discussion concerning the long-term requirements of the envisioned intervention is followed by a summary of the research and important findings concerning adolescent substance abuse in the United States today in the conclusion.
Review and Discussion
Current government initiatives/plans for addressing adolescent substance abuse
Given the severity, scope and importance of the problem, it is not surprising that there are a number of initiatives and programs that are sponsored by local, state and the national government that are designed to address substance abusing behaviors by young Americans today. What is truly surprising, however, is just how ineffective that many of these initiatives have been in addressing the problem, particularly in view of the enormous sums of money and effort that have been devoted to this issue over the past several decades. For instance, according to one authority, “We have been fighting drug abuse for almost a century. Four Presidents have personally waged war on drugs. Unfortunately, it is a war that we are losing” (The United States war on drugs, 2017).
This is not to say, however, that no progress has been achieved at all, but it is to say that changing public attitudes about marijuana, the most widely abused substance by young people at present, and its increasing availability nationwide, mean that it is likely that adolescents will continue to experiment with this illicit substance irrespective of efforts to stop it (Youth.gov, 2019). Notwithstanding the lack of substantive progress in this area, the various levels of government in the United States have continued their efforts to address substance abusing behaviors by adolescents. While state and local government programs vary significantly, some representative programs targeting adolescent substance abuse that are sponsored by the U.S. government include the following:
· Bureau of Indian Affairs, Office of Human Services;
· Centers for Disease Control and Prevention;
· National Institute on Alcohol Abuse and Alcoholism;
· Office of Safe and Drug-Free Schools; and,
· Substance Abuse and Mental Health Services Administration (Youth.gov, 2019).
Taken together, this broad-based approach to addressing adolescence substance abuse represents the best in available evidence-based strategies, but there remains a gap in the existing body of knowledge concerning the actual prevalence of substance use and abuse by young Americans today. For instance, the federal Web organization, Youth.gov emphasizes that, “Getting accurate estimates of the prevalence of substance use and abuse among youth is difficult. As a result, existing prevalence data likely is underestimated” (Youth.gov, 2019, para. 2). While there remains a lack of precision in determining the true prevalence of substance abuse among American adolescents, the problem is widely regarded as being sufficiently serious to warrant action by a number of health advocacy groups, including those discussed below.
Current health advocacy groups for this health issue
Like government efforts, there are literally thousands of health advocacy groups working at the local, state and federal levels that are focused on reducing adolescent substance abuse in the United States today. Some of the more well known of these national groups include the following:
· Al Anon and Alateen;
· Advocates for Recovery;
· Big Brothers and Sisters;
· Council on Alcohol and Drug Abuse; and,
· Friends in Recovery, Inc.
These groups frequently collaborate and partner with other organizations to help achieve their respective objectives, and they typically possess the expertise and experience that can improve the efficacy of the interventions used to address adolescent substance abuse (Barker, 2009). Despite the lack of substantive progress in reducing substance abusing behaviors by adolescents over the years, there have been some viable public health frameworks developed that can also help improve the effectiveness of interventions that are designed to address this problem and these issues are discussed further below.
Discuss the public health theory/model/framework which can be used to guide your program and intervention of the public health issue
The public health framework that will be sued to guide the envisioned program and intervention will follow the guidance provided in the 2016 U.S. Surgeon General's Report on Alcohol, Drugs, and Health. This report called for “a public health-based approach to addressing substance use disorders [which] is guided by essential services” (A public health-based approach, 2019, para. 4). Because substance abuse is a highly complex problem, the public health framework recommended by the Surgeon General is likewise comprehensive and multifaceted that:
· Defines the problem through the systematic collection of data on the scope, characteristics, and consequences of substance misuse;
· Identifies the risk and protective factors that increase or decrease the risk for substance misuse and its consequences, and the factors that could be modified through interventions;
· Works across the public and private sector to develop and test interventions that address social, environmental, or economic determinants of substance misuse and related health consequences;
· Supports broad implementation of effective prevention and treatment interventions and recovery supports in a wide range of settings; and
· Monitors the impact of these interventions on substance misuse and related problems as well as on risk and protective factors.” (A public health-based approach, 2019).
As noted above, the first step in this framework is especially needed since current estimates concerning the prevalence of adolescent substance abuse are considered inaccurate and most likely underestimate the true scope of the problem in the United States today. The remaining steps in this framework involve developing and implementing appropriate interventions and then evaluating them for their effectiveness in achieving the intended outcomes. Although the success rates of various strategies for addressing adolescent substance abuse have varied significantly, one intervention that has consistently proven most effective for many young people is behavioral therapies which are discussed below.
Describe the proposed intervention to address your identified public health issue.
Some of the most effective interventions that have been used for treating adolescent substance abuse are various types of behavioral therapies (Guo & Slesnick, 2016). In this regard, the National Institute on Drug Abuse (2019) concurs that, “Behavioral therapies are effective in addressing adolescent drug use. Behavioral therapies, delivered by trained clinicians, help an adolescent stay off drugs by strengthening his or her motivation to change” (para. 5). These desired outcomes are achieved using behavioral therapies by using various strategies that have proven effective in the past, including:
· Providing incentives for abstinence,
· Building skills to resist and refuse substances and deal with triggers or craving;
· Replacing drug use with constructive and rewarding activities;
· Improving problem-solving skills; and,
· Facilitating better interpersonal relationships (National Institute on Drug Abuse, 2019, para. 5).
It is important to note, however, that behavioral therapies are even more effective when they are used in a family therapy context so that adolescents’ parents and siblings can develop a better understanding of the problem and help provide additional support during the recovery phase (Guo & Slesnick, 2016).
How would you fund your public health program? What human resources would be needed?
The envisioned public health program would begin at the local level in a small Midwestern American city with a known adolescent substance abuse problem. The program would be funded through direct grants from the U.S. Centers for Disease Control and Prevention and the state government. In addition, funding would also be solicited from private donors in the local community with a vested interest in reducing adolescent substance abuse. The program will be modest in size at first, but will still require a multidisciplinary team to help assess young people’s needs and unique situations in order to develop and deliver individualized behavioral interventions (Burrow-Sanchez, 2009). Likewise, volunteers will be actively recruited from the local community to assist with the administration of the program, such as manning hotlines.
In addition, a program leader with experience in substance abuse programming and grant applications will also be required to head the program and coordinate the efforts of the staff members and volunteers. As the program identifies the most efficacious interventions for different individuals and achieves the desired outcomes, the program can be expanded to other parts of the city as well as other community in the state and ultimately nationwide.
Describe your evaluation plan. How would you know whether or not your public health issue has been effectively addressed?
As noted above, the first step in the public health framework that will be used for this program requires an accurate estimate of the prevalence and nature of the adolescent substance abuse problem in the targeted city. As also noted above, while accurate estimates are notoriously difficult to develop, a best effort must be made to collect this data in order to serve as a benchmark by which the effectiveness of the behavioral therapy interventions can be measured on a periodic basis to determine whether it has achieved its intended outcomes.
Describe long-term sustainability of your public health program. How could you help assure that gains were sustained?
One of the main points that emerged from the research was the fact that adolescent substance abuse is not going away completely any time soon (Schwartz & Smith, 2009), so there is an overarching need to ensure the program’s long-term sustainability. This will require ongoing fund-raising efforts, including the primary source of direct grants obtained from the federal and state governments as well as private donors. The effectiveness of these efforts can be improved by identifying optimal treatment strategies for young people and communicating clinical successes to grant providers, private donors and the general public.
Discuss any health-specific communication needs inherent in your program. How could social marketing and mass media help your program?
One of the more challenging aspects of treating adolescent substance abuse is the fact that the overwhelming majority of these young people do not regard their behaviors as problematic and are highly reluctant to actively engage in any treatment regimen. For instance, according to the National Institute on Drug Abuse (2019), “Adolescents with substance use disorders rarely feel they need treatment and almost never seek it on their own” (para. 7). This reluctance means that the program can benefit from social marketing using online resources that are popular with young people such as Facebook and Twitter. These online resources can serve as a valuable tool to help communicate the actual risks that are involved in even experimenting with illicit drugs and provide information to interested adolescents concerning where they can go for help in their own communities.
Likewise, high-profile coverage in the local mainstream media such as newspapers, television and radio can help spread the word concerning the availability of these treatment services and other community-based resources that are focused on addressing adolescent substance abuse. This approach is congruent with the guidance provided by the National Institute on Drug Abuse (2019) which advises, “Members of the community (such as school counselors, parents, peers, and mentors) can encourage young people who need help to get into treatment—and support them along the way” (para. 5). In sum, ensuring the long-term sustainability of the program envisioned herein will require developing and applying the best evidence-based behavioral therapies available, communicating any success stories that are achieved as well as continuous fund-raising efforts.
Conclusion
It is reasonable to suggest that adolescents have engaged in substance abusing behaviors since time immemorial, and it would be seriously misguided to believe the problem will simply go away on its own today. The research was consistent in showing that adolescence is a period in life that is characterized by experimenting with new things, including illicit drugs in many cases. The research also showed, though, that there are some treatment strategies available that can be used in a public health framework to achieve optimal results in addressing this nationwide problem. Therefore, it is also reasonable to conclude that the program outlines above, delivered in collaboration and partnership with existing organizations, can provide a valuable resource for American communities of any size.
References
A public health-based approach. (2019). Rural Health. Retrieved from https://www.ruralhealth info.org/toolkits/substance-abuse/1/public-health-based-approach.
Barker, P. (2009). Psychiatric and mental health nursing: The craft of caring. London: Hodder Arnold.
Burrow-Sanchez, J. J. (2009, Summer). Understanding adolescent substance abuse: Prevalence, risk factors, and clinical implications. Journal of Counseling and Development, 84(3), 283-288.
Guy, X. & Slesnick, N. (2016, April). Changes in family relationships among substance abusing runaway adolescents: A comparison between family and individual therapies. Journal of Marital and Family Therapy, 42(2), 299-302.
National Institute on Drug Abuse. (2019). Principles of adolescent substance use disorder treatment: A research-based guide. Retrieved from https://www.drugabuse.gov/ publications/principles-adolescent-substance-use-disorder-treatment-research-based-guide/principles-adolescent-substance-use-disorder-treatment.
Schwartz, R. C. & Smith, S. D. (2009, October). Screening and assessing adolescent substance abuse: A primer for counselors. Journal of Addictions & Offender Counseling, 24(1), 23-26.
The United States war on drugs. (2017 ). Stanford University. Retrieved from https://web. stanford.edu/class/e297c/poverty_prejudice/paradox/htele.html.
Youth.gov. (2019). Substance abuse agencies. Retrieved from https://youth.gov/youth-topics/substance-abuse/prevalence-substance-use-abuse-and-dependence.